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How to Get Through an MRI if You’re Claustrophobic

posted on WED, NOV 19 2014 by Center for Diagnostic Imaging

Even carrying a gallon of milk was painful for Shahina Nasar. She tried physical therapy, massage therapy, acupuncture and medication, but after six months of suffering from the sharp, stabbing pain in her right shoulder, her doctor ordered an MRI. The only problem: Shahina couldn’t make it through the exam. When she got on the table for her first MRI, she said she felt like she couldn’t breathe. “The feeling is like something is putting a pressure on your chest,” even though there was nothing there.

“Is it all in your head?” Seattle-based therapist Lisa Crunick explains, “I would say it’s in your subconscious, but I would say, in the moment, you don't have control.” Crunick says what’s driving a claustrophobic’s fear is the feeling you can’t escape. “They don’t identify with claustrophobia, they identify with what triggers them. They’ll say things like, ‘Oh, I don’t like to fly,’ or ‘I don’t ride in the backseat of the car,’ or ‘I don’t do elevators.’ If you start asking questions you realize it is the fear of being in an enclosed space.”

When it comes to getting an MRI, those feelings aren’t uncommon. Center for Diagnostic Imaging (CDI) Center Manager Desiree Rocovich estimates that during the screening call to set up an appointment, four out of 10 patients voice concern. The primary worry is staying static in the magnet, meaning that they have to stay still inside the machine until the imaging is complete. “We ask them, ‘Are you claustrophobic? Are you able to lay on your back?’ A lot of times we’re finding out they’re not able to do that,” Rocovich says.

Now, with different MRI options available to patients, they'll have a better chance of completing their exam so that they can get the answers they need.

Claustrophobia Option 1: High-Field Open MRI

CDI offers two alternatives to the traditional MRI. The first option is a High-Field Open MRI. Instead of a tube-like machine, this MRI has open sides and nothing pushes on your arms or shoulders. CDI technologist Terry Trescott operates the High-Field Open MRI and says many of her patients have a combination of a high body mass index (BMI) and claustrophobia. Terry says many people are relieved when they walk into the room and see the High-Field Open. “They’ve had a poor experience in the regular MRI and then they come here and see it’s more open, there’s more air flow. It just looks more comfortable to them.”

But the High-Field Open MRI doesn’t work for everyone. Shahina showed up for her appointment, took two sedatives and one look at the machine and backed out. “The technician was very sweet. He kept telling me this happens to a lot of people,” Shahina remembers. “He tried everything to calm me down. But I just couldn’t do it. I was too claustrophobic. It was way too close.”

Claustrophobia Option 2: Open Upright MRI

Running out of options and still in pain, Shahina made an appointment at CDI’s Renton center for an Open Upright MRI. During the exam the patient is usually seated or standing and there’s nothing in front of your face. The Open Upright MRI in Renton is the only one in Washington State and patients come from as far away as Alaska and Hawaii for exams.

Dr. Ranjeet Singh, a neuroradiologist at CDI, describes the Upright MRI as an open-architecture MRI. “People who have feelings of claustrophobia, they will find the MRI experience much more comfortable than in a traditional closed MRI scanner.” The Open Upright MRI’s magnet is not as strong as a traditional or High-Field Open MRI. Dr. Singh says that means the images may not be as clear, but it offers a good alternative for helping to diagnose a patient with claustrophobia.

3 Tips for Overcoming Claustrophobia

“It really is possible, it’s very possible to desensitize yourself to whatever it is that triggers the feeling of being terrified,” Therapist Lisa Crunick explains. She says that work can’t start the day before your scheduled MRI appointment, though. “It’s so doable,” Crunick says. “It’s really unnecessary for people who have fears like that to navigate their life around avoiding certain things.”

The first step to facing your fears, Crunick advises, is tracking down the initial event that caused them. In this video, she explains what therapists call the sensitizing event:

By identifying exactly what the trigger is, you can pull out the association so that the feelings are not so powerful. Then you create something that’s calming to you. Crunick points to three common therapy techniques to help you through that process of tackling your fear:

EFT-Emotional Freedom Technique: A therapist leads you through remembering an event and helps you “flatten” it, says Crunick. EFT uses the same pressure points that acupuncture has targeted for 5,000 years, but instead of using needles, the fingertips apply tapping pressure to those points. The psychological acupressure technique is combined with positive affirmations. See how EFT works.

NLP-Neuro-Linguistic programming: This technique is based on how language is used to create change. NLP research began in the mid 1970s and was based on work by the psychiatrist Milton Erikson who studied the relationship between the brain, language and the body.

Hypnosis: In this approach, a therapist helps you change your behavior by focusing your attention. The Mayo Clinic describes hypnosis as a point of heightened focus and concentration where you are more susceptible to suggestion. Crunick uses the example of the mind as a ski mountain with certain slopes you use often. Hypnosis can help you change your habits and try a new run.

In her experience, Crunick says it may only take a few sessions to conquer a life-long fear. “Absolutely there’s hope. It’s not a good idea to go through life with a fear like that. I’ve had people with extreme fears that have gotten over them.”

Helping Patients with Claustrophobia Regain Control

At CDI, Desiree Rocovich estimates 80% of patients successfully complete a traditional MRI with some help. Some techniques that can reduce the anxiety that comes with feelings of claustrophobia include focused breathing and covering your eyes with a towel during the exam. CDI also offers headphones for listening to music and, for Open Upright MRI patients, watching TV is an option. Choosing the MRI procedure that’s right for you and finding a compassionate, skilled team can alleviate apprehension.

CDI technologist Leslie Young says the calming voice of an experienced technologist can make a world of difference for her patients. “We will not make you do anything that you can’t do. Period,” Leslie explains. “You are in charge. If you need us to stop, we stop. We’re trying to do the best we can for you to give your doctor the information that they need, but we’re not going to do anything that’s going to stress you out. We’re not going to strap you down.”

After guiding patients for years through both traditional and Open Upright MRIs, Leslie says the pay-off is the reaction she gets when the exam is over. "I’ve gotten hugs. I’ve gotten lots and lots of thank you’s and I couldn’t have done this without you."